SCHISTOSOMIASIS AND WATER RESOURCES DEVELOPMENT: A RE-EVALUATION OF AN IMPORTANT ENVIRONMENT-HEALTH LINKAGE

Many people argue that water resource development projects have negative health effects. In particular, they claim that an increase in schistosomiasis almost automatically results from building dams, irrigation systems, and other water-related activities in regions endemic for the disease. However, this literature review finds many cases where no such increase seems to occur. Some people explain this phenomenon by the adopting of preventive measures, such as providing adequate sanitary and water facilities and appropriate water management practices. Even when these are absent, there is often no increase in schistosomiasis transmission. Ecological variations in snail populations may be more important. Generalizations are usually misleading. For example, in Mali and northern Ghana, some studies associate small earthen dams with schistosomiasis transmission. But other studies from northern Cameroon, Burkina Faso, northern Nigeria, and northern Ghana did not find any transmission of schistosomiasis from impounding small bodies of water. In Asia, schistosomiasis occurs only with specific methods of rice cultivation in certain areas of China and the Philippines. In Africa, most evidence fails to show an association between irrigated rice cultivation and schistosomiasis. Water resources and agricultural development projects often receive unfair blame for creating health hazards such as schistosomiasis. The Aswan High Dam in Egypt is the most notable case. It might be prudent, however, for planners and policy makers to protect against possible increases in schistosomiasis transmission from water resource development projects. As part of project proposals, careful studies should be made of snail species and of existing patterns of schistosomiasis transmission. Further, a percentage of investment and operating funds should be allocated for appropriate water supply and sanitation and for health care to treat local populations for any water-related or other ailments associated with the project.Environmental Economics and Policy,

Costs and benefits of folic acid fortification in the United States: economic analysis, regulatory action, and public health

ManuscriptThe United States Food and Drug Administration (FDA) required that as of January 1, 1998, manufacturers of enriched cereal- grain products fortify their products with folic acid to reduce the number of pregnancies affected by a neural tube defect (NTD). Prior to adoption of the regulation in 1996, three economic evaluations projected the net economic benefits or cost savings of folic acid fortification. The expected percentage decline in NTDs in these three studies was between 2.6% and 10.5%. Birth defects surveillance data indicate that since fortification there has been a 20% to 30% decline in births with either spina bifida or anencephaly. We estimate that folic acid fortification is associated with an economic benefit of $425 million per year in the United States and constitutes a major public health success that has resulted from regulatory actio

Newborn screening for congenital hypothyroidism and congenital adrenal hyperplasia : the balance of benefits and costs of a public health success

Version anglaise de : Van Vliet, G. Grosse, S. D., Dépistage néonatal de l’hypothyroïdie congénitale et de l’hyperplasie congénitale des surrénales : Bénéfices et coûts d’un programme de santé publique à succès. Médecine/Sciences n° 4, vol. 37, avril 2021. doi:10.1051/medsci/2021053.Newborn screening is an important public health program and a triumph of preventive medicine. Economic analyses show that the benefits of newborn screening clearly outweigh the costs for certain diseases but not necessarily for other ones. This is due to the great diversity of the natural history of the diseases detected, to the fact that each of these diseases considered individually is rare, and to differences in the effectiveness of interventions. In addition, the benefit cost ratio of screening for a particular disorder may differ between countries, specifically between high-income and low- and middle-income countries. The burden of a disorder may also be alleviated by increased clinical awareness and effective clinical services, even in the absence of newborn screening. In this article, the authors focus on economic analyses of newborn screening for primary congenital hypothyroidism, which has been in place in high-income countries for roughly 40 years, and for classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Screening for the latter is not yet universal, even in high-income countries, although the lack of universal implementation may reflect factors other than economic considerations

Private Insurance Reimbursements for Newborn Hearing Screening in the United States, 2013-2014

The purpose of this study was to describe private insurance reimbursements for newborn hearing screening (NBHS) in the United States. Data from the MarketScan® Commercial Databases were used to estimate reimbursement for privately insured infants born between January 1, 2013–December 31, 2014. Estimates were based on billed claims for hearing-related services during infancy (71,820 infants with inpatient NBHS, 1,104 with outpatient NBHS). Median reimbursement for NBHS performed in a hospital setting was $148.00 (range$113.51–$196.02) when billed as an inpatient service and$136.48 (range $86.08–$220.15) when billed as an outpatient service. Both reimbursement amounts were three times greater than the median reimbursement of $41.60 (range$30.48–$49.25) for NBHS billed in conjunction with an office visit

Your Governance or Mine?

In response to criticism directed at the resource sector's corporate governance, this paper examines the corporate governance and underlying firm characteristics of resource development stage entities (DSEs) relative to a size-matched sample of non-resource firms. We find that resource DSEs have different governance characteristics in the measures of board independence, chair/CEO duality and CEO cash bonuses. Furthermore, there are differences in the information environment measures of analyst following, debt levels, stock market return and stock turnover. Considering we document substantial differences in underlying firm characteristics, corporate governance differences are likely appropriate to the mining industry and should not be uniformly labelled as 'bad'. Our results suggest that media rankings based on corporate governance scores may not accurately portray the resource sector. Overall, our results are of interest to Australian investors and regulators and contribute to a broader understanding of contextually contingent corporate governance. © 2011 CPA Australia

What Contribution Did Economic Evidence Make to the Adoption of Universal Newborn Hearing Screening Policies in the United States?

Universal newborn hearing screening (UNHS), when accompanied by timely access to intervention services, can improve language outcomes for children born deaf or hard of hearing (D/HH) and result in economic benefits to society. Early Hearing Detection and Intervention (EHDI) programs promote UNHS and using information systems support access to follow-up diagnostic and early intervention services so that infants can be screened no later than 1 month of age, with those who do not pass their screen receiving diagnostic evaluation no later than 3 months of age, and those with diagnosed hearing loss receiving intervention services no later than 6 months of age. In this paper, we first document the rapid roll-out of UNHS/EHDI policies and programs at the national and state/territorial levels in the United States between 1997 and 2005. We then review cost analyses and economic arguments that were made in advancing those policies in the United States. Finally, we examine evidence on language and educational outcomes that pertain to the economic benefits of UNHS/EHDI. In conclusion, although formal cost-effectiveness analyses do not appear to have played a decisive role, informal economic assessments of costs and benefits appear to have contributed to the adoption of UNHS policies in the United States

Health policy for sickle cell disease in Africa: experience from Tanzania on interventions to reduce under-five mortality.

Tanzania has made considerable progress towards reducing childhood mortality, achieving a 57% decrease between 1980 and 2011. This epidemiological transition will cause a reduction in the contribution of infectious diseases to childhood mortality and increase in contribution from non-communicable diseases (NCDs). Haemoglobinopathies are amongst the most common childhood NCDs, with sickle cell disease (SCD) being the commonest haemoglobinopathy in Africa. In Tanzania, 10,313 children with SCD under 5 years of age (U5) are estimated to die every year, contributing an estimated 7% of overall deaths in U5 children. Key policies that governments in Africa are able to implement would reduce mortality in SCD, focusing on newborn screening and comprehensive SCD care programmes. Such programmes would ensure that interventions such as prevention of infections using penicillin plus prompt diagnosis and treatment of complications are provided to all individuals with SCD

Newborn screening for cystic fibrosis: evaluation of benefits and risks and recommendations for state newborn screening programs

In November 2003, CDC and the Cystic Fibrosis Foundation cosponsored a workshop to review the benefits and risks associated with newborn screening for cystic fibrosis (CF). This report describes new research findings and outlines the recommendations of the workshop. The peer-reviewed evidence presented at the workshop supports the clinical utility of newborn screening for CF. Demonstrated long-term benefits from early nutritional treatment as a result of newborn screening for CF include improved growth and, in one study, cognitive development. Other benefits might include reduced hospitalizations and improved survival. Mixed evidence has been reported for pulmonary outcomes. Newborn screening in the United States is associated with diagnosis of CF a median of 1 year earlier than symptomatic detection, which might reduce the expense and anxiety associated with workup for failure to thrive or other symptoms. Certain psychosocial risks for carrier children and their families (e.g., anxiety and misunderstanding) are associated with newborn screening. Exposure of young children to infectious agents through person-to-person transmission in clinical settings, although not an inherent risk of newborn screening, is a potential cause of harm from early detection. Involving specialists in CF care and infection control, genetic counseling, and communication can minimize these potential harms. Although screening decisions depend on a state\u27s individual resources and priorities, on the basis of evidence of moderate benefits and low risk of harm, CDC believes that newborn screening for CF is justified. States should consider the magnitude of benefits and costs and the need to minimize risks through careful planning and implementation, including ongoing collection and evaluation of outcome data